Dose reduction, discontinuation benefited psychosis patients in long term

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Contrary to received wisdom, patients who reduced or discontinued antipsychotics "remitted" more often than patients who were maintained on the drugs.

 

http://www.healio.com/psychiatry/schizophrenia/news/online/%7B1EDFB0BB-DACB-4EE7-B298-51D774D209FD%7D/Dose-reduction-discontinuation-benefited-psychosis-patients-in-long-term

Dose reduction, discontinuation benefited psychosis patients in long termWunderink L. JAMA Psychiatry. 2013;doi:10.1001/jamapsychiatry.2013.19.July 8, 2013Patients with remitted first-episode psychosis who reduced or discontinued their antipsychotic drug treatments experienced twice the recovery rate over 7 years compared with patients who maintained their treatments, researchers reported.....In light of these newest data, however, a patient’s ability to function perhaps should be taken into consideration when determining a treatment’s success, according to the researchers.“The present guidelines are directed mainly toward the prevention of relapse,” they wrote. “However, awareness is growing that, in addition to relapse, functional status should be included in outcome evaluation. Therefore, recovery, including both symptomatic and functional remission, would be a more adequate concept for outcome evaluation.”The study followed 128 patients who originally participated in a 2-year randomized clinical trial comparing dose reduction/discontinuation (DR) with maintenance treatment (MT) over 18 months. After 7 years, patients were contacted and assessed for symptomatic and functional remission. One hundred three patients (80.5%) were included in the final analyses.Results showed that DR patients had a significantly higher remission rate (40.4%) vs. MT patients (17.6%), with an odds ratio of 3.49 (P=.01). Treatment success in the DR group was related to greater rates of functional, but not symptomatic, remission rates.“The present study poses some serious considerations about the long-term benefits of antipsychotic MT following remitted FEP and stresses the need for studying alternative treatment strategies,” the researchers wrote.

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More about this here http://survivingantidepressants.org/index.php?/topic/5434-wunderink-2013-recovery-in-remitted-first-episode-psychosis-at-7-years-of-follow-up-of-an-early-dose-reductiondiscontinuation-or-maintenance-treatment-strategy/